Efficacy and safety of a novel diamond tip temperature-controlled catheter for left atrial posterior wall isolation under electrogram guidance.

BACKGROUND

The effectiveness of a novel diamond tip temperature-controlled ablation (DTA) catheter for left atrial posterior wall isolation (LAPWI) remains unclear.

OBJECTIVE

This study evaluated the efficacy and safety of the DTA catheter for LAPWI under electrogram (EGM) guidance.

METHODS

This single-center observational study compared the first-pass LAPWI success rate among three groups: DTA with EGM guidance (n = 82), conventional irrigation catheter with EGM guidance (Irri with EGM guidance; n = 92), and Irri without EGM guidance (n = 93), using fixed energy parameters (30 W, 15-20 s).

RESULTS

DTA with EGM guidance had a significantly higher incidence of first-pass LAPWI success (93%, 76/82) than that of Irri without EGM guidance (54%; 50/93) (p < 0.001) and had a success rate comparable to that of the Irri with EGM guidance (97%; 89/92). Post hoc Bonferroni analysis demonstrated that the DTA with EGM guidance group had a significantly shorter radiofrequency-energy delivery duration (158 ± 63 s) than that of the Irri with EGM guidance group (229 ± 131 s; p < 0.0001) and the Irri without EGM guidance group (243 ± 185 s; p < 0.001). The DTA with EGM guidance group had a higher average RF power (45.1 ± 5.6 W) than the Irri with (31.2 ± 2.2 W; p < 0.0001) and without EGM guidance groups (28.0 ± 8.9 W; p < 0.001). No significant complications were observed.

CONCLUSIONS

The novel DTA catheter with EGM guidance achieved a high first-pass LAPWI success rate. The novel DTA catheter with short energy delivery and high average radiofrequency (RF) energy delivery under EGM guidance can be effectively applied in LAPWI.